MEDICATION ADHERENCE IN PSYCHIATRY: A COMPARATIVE ANALYSIS OF THEORETICAL EXPLANATORY MODELS. PART TWO: SUBJECTIVE, BEHAVIORAL, AND INTERPERSONAL APPROACHES

Abstract

The present study constitutes the second part of a comprehensive comparative analysis of theoretical explanatory models of medication adherence in psychiatry. It continues the analysis initiated in the first part, which examined the evolution of the construct, the World Health Organization’s multidimensional framework, the Health Belief Model, and the Theory of Planned Behavior. The second part focuses on models that deepen the understanding of the subjective, behavioral, and interpersonal dimensions of adherence: the Common-Sense Model of Illness Representations, the Necessity-Concerns Framework, the Capability-OpportunityMotivation-Behavior model, the therapeutic alliance, and shared decision-making. In conclusion, an integrative comparative synthesis is proposed, according to which adherence is understood as a dynamic process arising from the interaction among the clinical condition, personal beliefs, the patient’s lived experiences, the therapeutic relationship, the social environment, and the conditions enabling the actual implementation of the treatment plan.